This study was funded by the Otolaryngology Research and Education Fund at Stanford University.
Long-term great auricular nerve morbidity after sacrifice during parotidectomy†
Article first published online: 27 APR 2009
Copyright © 2009 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 119, Issue 6, pages 1140–1146, June 2009
How to Cite
Ryan, W. R. and Fee, W. E. (2009), Long-term great auricular nerve morbidity after sacrifice during parotidectomy. The Laryngoscope, 119: 1140–1146. doi: 10.1002/lary.20246
Dr. Ryan had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
- Issue published online: 20 MAY 2009
- Article first published online: 27 APR 2009
- Manuscript Accepted: 9 FEB 2009
- Great auricular nerve;
- nerve morbidity;
- nerve sacrifice;
To clarify the extent and patient perspectives of great auricular nerve (GAN) morbidity and recovery after nerve sacrifice during parotidectomy 4 to 5 years after surgery.
Twenty-two patients who underwent parotidectomy with GAN sacrifice and were previously studied for GAN sensory outcome during the first postoperative year. We performed light touch sensation tests on each patient to develop an ink map representing anesthesia and paresthesia in the GAN sensory territory; patients also completed an outcomes questionnaire.
Nineteen (86%) of 22 patients completed follow-up. One patient completed the questionnaire over the phone. The prevalence and average areas of anesthesia and paresthesia decreased since the first postoperative year according to sensory testing and patient scoring. At 4 to 5 years, 47% (9 of 19) of the patients had anesthesia, 58% (11 of 19) had paresthesia, and 26% (5 of 19) had neither anesthesia nor paresthesia during sensory testing. Patients reported that the GAN dysfunction brought them no to mild inference with their daily activities. At a mean point of 2 years, 70% (14 of 20) patients felt that their sensory symptoms had either completely abated or stabilized.
The posterior branch of the GAN should be preserved if it does not compromise tumor resection. If this is not possible, the patient and surgeon should be comforted in that only minor, if any, long-term disability will ensue. Laryngoscope, 2009